Women choosing caesarean have low death rate

Women who have a planned caesarean section birth have the lowest mortality rate, new data has shown.

Experts have long been concerned about rising surgical births in the UK because of the risks involved.

But new research now suggests an elective, or pre-planned caesarean, may be the safest of all options.

Many celebrities have been criticised for having an elective caesarean and described as "too posh to push" when in most cases there is a good medical reason why the baby needs to be delivered surgically, such as the mother having very narrow hips or a history of difficult labours.

The Birth Trauma Association found that of the 2,113,831 women who delivered a baby after 24 weeks gestation between 2003 and 2005, one in 10 had a caesarean before labour had begun.

This compared to 74 deaths amongst the remaining women who had a natural birth or an emergency caesarean section, giving a mortality rate of 0.39 per 10,000.

Maureen Treadwell, from the Birth Trauma Association, said: "Maternal death is very, very rare so it is important women are not worried by this. However, women with potential complications like very small women, those with large babies or requiring induction, may like to discuss the risks and benefits of elective caesarean with their doctors.

"We certainly see women with obstetric problems who have been encouraged to go for a normal delivery. These women can go through a terrible experience and end up deeply traumatised and very ill.

"There has been a lot of confused thinking about caesareans. We need to talk either about elective caesareans or emergency caesareans - not treat them as the same procedure. They have entirely different risk factors."

Although maternal deaths are extremely rare, the research challenges the government's policy of reducing caesarean rates.

A similar policy has alreay been abandoned by the National Institute of Health in the US, which now advocates advising women of the risks and benefits based on individual circumstances.

Caesarean data in the UK can be difficult to interpret precisely with government statistics sometimes inconsistent and the recording of elective, scheduled, urgent and emergency caesareans sometimes confused.

However, the BTA said the overwhelming majority of women who undergo scheduled or elective caesareans have risk factors and it was "extremely surprising" to find they have a lower rate of maternal mortality.

It said clinicians should identify women at greater risk of emergency caesarean and engage them in a decision about how they choose to deliver their baby.

Ms Treadwell said: "The important issue is that women get good quality information and that the individual choice they make is respected."